Department of Pediatrics (Drs MacMaster, Barlow, Yeates, and Brooks), Department of Psychiatry (Dr MacMaster), Department of Neuroscience (Mr McLellan), Department of Radiology (Dr Harris), Department of Clinical Neurosciences (Drs Barlow, Yeates, and Brooks), Department of Psychology (Dr Langevin, Yeates, and Brooks), Faculty of Kinesiology (Mr Virani), Alberta Children's Hospital Research Institute (Drs Harris, Barlow, Langevin, Yeates, Brooks and Mr Virani), and Hotchkiss Brain Institute (Drs Harris and Yeates), University of Calgary, Calgary, Alberta, Canada; Strategic Clinical Network for Addictions and Mental Health, Alberta Health Services, Calgary, Alberta, Canada (Dr MacMaster); Neuropsychology Service, Alberta Children's Hospital, Calgary, Alberta, Canada (Mr Virani and Dr Brooks); and Child Health Research Centre, University of Queensland, Brisbane, New South Wales, Australia (Dr Barlow).
J Head Trauma Rehabil. 2020 Mar/Apr;35(2):E127-E135. doi: 10.1097/HTR.0000000000000535.
Despite increasing interest in the neurobiological effects of concussion in youth, a paucity of information is available regarding outcomes long after injury. The objective of this study was to determine the association between a history of concussion and the putative neuronal marker N-acetyl-aspartate (NAA) in the dorsolateral prefrontal cortex (DLPFC) in youth.
Outpatient clinic in a children's hospital.
Youth with concussion (N = 35, mean = 2.63, SD = 1.07 years postinjury) and youth with a nonconcussive orthopedic injury (N = 17) participated.
A cross-sectional proton magnetic resonance spectroscopy (H-MRS) study.
The primary outcome measure was NAA concentration in the right and left DLPFCs.
We observed lower levels of NAA in the right DLPFC in youth with past concussion (F = 3.31, df = 4,51, P = .018) than in orthopedic controls but not in the left DLPFC (F = 2.04, df = 4,51, P = .105). The effect of lower NAA concentrations in the right DLPFC was primarily driven by youth with a single prior concussion versus those with multiple concussions. NAA in the left DLPFC, but not in right DLPFC, was associated with worse emotional symptoms in youth with concussion.
The presence of lower levels of DLPFC NAA suggests potential association of concussion in youth, although further investigation is needed, given that the result is driven by those with a single (and not multiple) concussion. Exploration of applying MRS in other brain regions is also warranted.
尽管人们对青少年脑震荡的神经生物学影响越来越感兴趣，但关于受伤后很长时间的结果的信息却很少。本研究的目的是确定青少年脑震荡病史与背外侧前额叶皮质（DLPFC）中假定的神经元标志物 N-乙酰天冬氨酸（NAA）之间的关联。
儿童医院的门诊诊所。
有脑震荡的年轻人（N=35，平均=2.63，SD=1.07 年）和有非脑震荡性骨科损伤的年轻人（N=17）参加了研究。
一项横断面质子磁共振波谱（H-MRS）研究。
主要结果指标是右和左 DLPFC 中的 NAA 浓度。
我们观察到过去有脑震荡的年轻人右侧 DLPFC 的 NAA 水平较低（F=3.31，df=4,51，P=0.018），而不是在左侧 DLPFC（F=2.04，df=4,51，P=0.105）。右侧 DLPFC 中 NAA 浓度较低的影响主要是由单次脑震荡的年轻人驱动的，而不是多次脑震荡的年轻人。在有脑震荡的年轻人中，左侧 DLPFC 的 NAA 与更严重的情绪症状有关，但右侧 DLPFC 的 NAA 则没有。
DLPFC NAA 水平较低表明青少年脑震荡的潜在关联，尽管需要进一步调查，因为这一结果是由单次（而不是多次）脑震荡引起的。探索在其他脑区应用 MRS 也是值得的。
